Sometimes, an abnormal number of fat cells will accumulate in isolated areas of the face and neck. This excess fatty tissue may originate for various reasons. It is not just a problem of the overweight, although a history of a general weight gain is common among patients who seek liposuction . That’s because one of the hardest places to lose weight is in the neck and jowl areas.
Another common reason for excess fatty tissue is heredity. Even younger people may find that, although not overweight, they have the same round, plump face or neck as their parents.
A third reason is the natural aging process. As we age, our skin loses its elasticity and gravity causes it to sag. In the neck and jowl areas, more fat can be accommodated than before.
Whatever the reason, this excess fatty tissue is unsightly to many people. Its removal by a facial plastic surgeon often can improve the appearance.
The operation used to remove excess pockets of fat is called facial suction lipectomy, or liposuction. The procedure is not a substitute for weight loss and exercise if excessive facial fat is part of an overall weight problem.
Liposuction is performed by inserting a special instrument ( a cannula) beneath the skin through a tiny incision placed either below the chin or just behind the earlobe in a natural crease or fold. A suction apparatus connected to the cannula removes the unwanted fat cells. These cells will not be replaced, since fat cells do not multiply (fat cells increase and decrease in size, not number). After the fat is removed, the overlying skin collapses and shrinks to create a smooth appearance. The more elastic the skin, the better the result.
Liposuction can be done alone or in combination with other facial plastic surgery procedures. For example, combining liposuction with a facelift may help create a better overall result if skin elasticity is poor, since excess fat is removed at the same time as excess sagging skin.
Combining liposuction with a chin implant can help correct a receding or a double chin.
Deciding on an Operation
Anyone interested in facial liposuction should consult a facial plastic surgeon. During the initial visit, Dr. Swenson makes a thorough evaluation of the face and neck to determine whether surgery is indicated and whether it might be combined with another procedure for best results. He then will discuss any questions and concerns related to the surgery.
Important considerations for surgery, in addition to the skill of the surgeon, are the patient’s realistic expectations about the results of the surgery and his or her general emotional state. Mental attitude is as important as the ability to heal in evaluating candidates for facial plastic surgery.
Once surgery is agreed upon, preoperative photographs are taken to help Dr. Swenson plan the operation. These photographs usually are compared with similar ones taken sometime after surgery and serve as a permanent before and-after record of the results.
Where Surgery is Performed
Facial liposuction can be performed in a hospital, an ambulatory surgical care center, or an office surgical suite, depending on the patient’s and the physician’s preference. It usually is performed safely as an outpatient procedure; however, the surgeon may recommend a short stay in the hospital.
Keeping the Patient Comfortable
Pre-operative medications to relieve tension and local anesthetics to numb the areas to be liposuctioned commonly are used for surgery. These should keep the patient comfortable and free of pain. If desired, general anesthesia can be used. Dr. Swenson will discuss which anesthetic technique is suitable for each individual case.
The Immediate After-Effects
After the operation, a snug dressing is placed around the face and neck. It is removed the next day and you may be advised to wear a “chin strap” (an elastic bandage placed under the chin and tied on top of the head) for a few days and several weeks at night. Some swelling and bruising can be expected. The bruising usually subsides within two or three weeks, while the swelling takes a bit longer to go away. Mild discomfort, which may be present for a short time after surgery, usually is easily controlled with medication. Significant pain is quite rare.
The Results to Expect
Depending on the inherent elasticity of the skin and the amount of postoperative swelling, there may be no noticeable results until one or two months after surgery. On the other hand, if the patient’s skin is relatively healthy with good elasticity (allowing the skin to contract rapidly), and if there is minimal swelling, the results may be immediately recognizable, and often dramatic improvement can be easily seen early in the postoperative course. Whatever the case, the final result should be evident six months after the surgery. At that point, all of the swelling is gone, and any irregularities or firmness noted immediately after surgery will have softened and smoothed out. Just how much improvement will be made depends on the individual’s physical characteristics and the extent of the surgery.
The risks are minimal when facial liposuction is performed on a patient. There are inherent risks in any surgery, however, and these should be discussed thoroughly with your facial plastic surgeon. Many thousands of facial liposuction operations are performed successfully and safely each year.
Fees for facial plastic surgery and operative facilities vary widely and depend on the extent and complexity of the surgery. Dr. Swenson and his staff will discuss costs before the operation.
Fees for facial plastic surgery generally are expected in advance because this type of surgery is not covered by insurance. The best way to find out if an insurance company will consider a claim is to consult an insurance company representative in advance of the surgery.